Managing Claims in the Electronic Claims Insurance Queue

To access the Electronic Claims Insurance Queue window, select Billing > Insurance Processing > Create Electronic Claims Batch.

The Electronic Claims Insurance Queue window indicates whether an attachment is required for a claim, or if it has already been sent or received by NEA.

If an attachment is required, the claim is automatically put on hold so it cannot be transmitted before the attachment is sent. If you manually remove the On hold status and send the claim electronically, the NEA Status changes to Ignored.

Send the attachments to NEA before sending a claim so that the NEA tracking number is updated in the claim. A few insurance companies require that the claim be sent first; this is indicated in the NEA payer list.

The NEA Status column displays one of the following statuses for each claim:

BlankBlankDisplays for claims for which the insurance companies do not have NEA payer information, or for claims that do not require an attachment, or those created prior to installing the WinOMS software v7.0.17.
RequiredRequiredDisplays for a claim with procedure codes that require attachments to be sent, but which have not yet been created or submitted electronically.
In ProgressIn ProgressDisplays for a claim that had attachments created and sent, but has not received confirmation from NEA.
PendingPendingDisplays for a claim whose insurance company does not want attachments until requested.
Not SentNot SentDisplays for a claim with attachments that were created and saved to be batched and sent later.
IgnoredIgnoredDisplays for a claim that originally had an NEA status of Required, but has already been submitted electronically.
RejectedRejectedDisplays for a claim whose attachments were rejected by NEA.
NEA#xxxxxxxNEA#xxxxxxxDisplays for a claim whose attachments were successfully transmitted to NEA. This number is also displayed in the claim's Notes field.

You can highlight a claim in the queue, right-click, and select from the following actions:

Change NEA StatusChange NEA StatusDepending on the status of the claim, enables you to select Ignored or Required.

Create/Edit Claim AttachmentCreate/Edit Claim AttachmentDisplays the Create NEA Attachment for Claim window.

Delete Claim AttachmentDelete Claim AttachmentDeletes the selected attachment from the claim.

View Claim Attachment HistoryView Claim Attachment HistoryDisplays the Claim Attachments window.

Submit AttachmentsSubmit AttachmentsSubmits saved attachments to the NEA FastAttach service.

Update Claim NEA StatusUpdate Claim NEA StatusUpdates the attachment status of unsent NEA claims to either In Progress or NEA#xxxxxxx.

The new right-click menu options are also available in the Insurance Processing Queue window for claims that have been changed from paper to electronic.

Click Details to display the Claim Detail window for the selected claim.